中文姓名/Chinese Name (if any):

国籍/Nationality:

性别/Sex: □ 男Male □女Female

出生地/Place of Birth:

婚姻状况/Marital Status:

□ 未婚Single □已婚Married

出生日期/Date of Birth:

Year: Month: Day:

护照号/Passport Number: 有效期/Passport Valid Until Year: Month: Day:

通讯地址/Detailed Postal Address (including post code) which the admission documents are to be sent to:

电子邮件/Email:

电话/Phone:

学历/Highest Education Level:

职业/Occupation:

单位或学校/Name ofEmployer or School:

汉语/Chinese Level: □零起点/beginner □初级/elementary □中级/intermediate □中高级/good □高级/advanced

学习身份/Status: □语言生/Chinese Language Student □本科生/Undergraduate □硕士生/Master □其他/Other

专业/Major of Study at TUT, China (None Chinese Language Student):

学习期限/ 自年月日至年月日

Duration of Study at TUT: From Year Month Day to Yea Month Day

住宿要求/Dorm Reservation: Refer to the page of “Expenses” on our website and mark your room preference below. (Note: The choice of rooms is on a first-come-first-choice basis.)

□ 学术交流教育中心（留学生宿舍）/ Academic Exchange Center (International Student Dormitory)

□ 双人间Double Room 长期long –term (4 months or above) students：人民币45元/天/床RMB45/day/bed；

短期short–term (below 4 months) students：人民币50元/天/床RMB50/day/bed

经济来源/ □ 奖学金/Scholarship (if yes, specify source):

Source of Funding: □自费/Self-support □ 其他/Other

推荐单位/Recommending School or Agency (if none, fill in “self-reference”):

在华担保人/Guarantor in China (If any): Name Phone Email

你是如何得知我们学校的/Where did you hear about our university?

□ Google □ MSN □ Yahoo □中介/Agent □学校/School □亲朋/Friend/Relative □其他/Other

申请人保证/I hereby affirm that:

□ 上述各项中所提供的情况是真实的/All the information in this form is true and correct.

□ 在中国期间,遵守中国的法律和学校的规章制度/I shall abide by the laws of China and school regulations.

□ 接受天津理工大学对本人在华学习的安排/I accept the arrangements of TUT regarding my studies in China.

日期/Date: 申请人签字/Applicant Signature: